开腹与腹腔镜胆囊切除术治疗胆囊结石疗效观察

目的:探究开腹胆囊切除术与腹腔镜胆囊切除术治疗胆囊结石80例的疗效。方法:选择2013年3月~2016年5月我院收治的胆囊结石患者80例,随机分为观察组和对照组,每组40例。对照组予以开腹胆囊切除术,观察组予以腹腔镜胆囊切除术。记录两组患者手术情况和并发症发生情况。结果:对照组与观察组相比,手术用时、胃肠功能恢复时间、术中出血量、住院天数均显著提高,差异有统计学意义(P<0.05);对照组并发症总发生率与观察组相比明显提高,差异有统计学意义(P<0.05)。结论:与开腹胆囊切除术相比,对胆囊结石患者采用腹腔镜胆囊切除术治疗效果更优,能有效改善各项手术指标,缩短治疗时间、降低并发症发生率,值得临床应用与推广。     

腹腔镜下胆囊切除术对胆囊结石患者的疗效分析

目的 分析在治疗胆囊结石中应用腹腔镜下胆囊切除术的治疗效果.方法 选取该院2017年5月—2019年5月期间收治的90例胆囊结石患者作为该次研究对象,依据入院先后顺序分为对照组和观察组,各45例,对比两组患者治疗效果.结果 组间术中情况对比,观察组手术时间更短(62.5±9.5)min、术中出血量更少(41.5±6.5...     

糖尿病对胆囊结石行腹腔镜胆囊切除术的影响

目的 探讨糖尿病是否为胆囊结石行腹腔镜胆囊切除术的的危险因素。方法 胆囊结石行腹腔镜胆囊切除术患者2540例，对其年龄、性别、美国麻醉医师协会（ASA）危险因素分类、实验室检查、手术记录、并发症的发生率及住院时间进行分析。结果 糖尿病患者和非糖尿病患者的白细胞计数、胆红素、淀粉酶水平差异无显著性，糖尿病患者的手术及术后并发症的发生率以及中转开腹率明显增高。2组手术时间及住院时间差异无显著性。结论 糖尿病患者行腹腔镜胆囊切除术后具有较高的并发症发生率和中转开腹率。     

腹腔镜胆囊切除术治疗胆囊结石的疗效及安全性分析

目的 探讨腹腔镜胆囊切除术治疗胆囊结石患者的疗效及对并发症的影响.方法 选取2018年2月～2020年2月我院收治的胆囊结石患者88例,按随机数字表法分为观察组和对照组各44例.对照组行开腹胆囊切除术,观察组行腹腔镜胆囊切除术.比较两组手术及术后恢复相关指标、并发症发生情况.结果 观察组术中出血量少于对照组,胃肠功能恢...     

腹腔镜胆囊切除术在肝硬化合并胆囊结石中的临床应用

目的：解决肝硬化合并胆囊结石的手术问题。方法：把56例肝硬化合并胆囊结石患者作为研究对象。实施腹腔镜胆囊切除术。结果：全部患者术后恢复良好,均无并发症。结论：腹腔镜胆囊切除术对肝硬化患者来说是安全有效的。     

腹腔镜胆囊切除术治疗58例老年胆囊结石的疗效观察

选择2011年4月~2013年4月我院收治的112例老年胆囊结石患者为研究对象,随机分为观察组58例和对照组54例。观察组采用腹腔镜胆囊切除术进行治疗,对照组采用小切口胆囊切除术治疗,比较两组患者手术期的基本情况(手术出血量、手术时间、时间、卧床时间以及住院时间等)及术后并发症发生情况(切口感染,尿路感染,腹腔感染,肺部感染,心力衰竭)。结果观察组在基本情况方面均要优于对照组,观察组并发症发生率明显低于对照组,两组差异显著(P0.05)。腹腔镜胆囊切除术治疗老年胆囊结石痛苦小、并发症少、恢复快,值得临床的大力推广。     

观察经腹腔镜逆行胆囊切除术和次全胆囊切除术治疗复杂良性胆囊结石的疗效

选取我院2010年1月～2012年2月收治的68例复杂良性胆囊结石患者,随机分为试验组和对照组各34例,对照组患者采取经腹腔镜逆行胆囊切除术进行治疗,试验组患者采取次全胆囊切除术进行治疗,分析对比患者治疗效果与各项指标情况。结果试验组与对照组在中转开腹率、手术后肠胃功能恢复所需时间、腹腔引流量、手术并发症以及住院时间方面并无显著差异,P〉0.05;试验组患者在手术持续时间手术中出血量、手术中补液量方面均少于对照组,对比P〈0.05,具有统计学意义。腹腔镜逆行胆囊切除术和次全胆囊切除术治疗复杂良性胆囊结石的手术效果相仿,但腹腔镜次全胆囊切除术的手术时间更短,手术中出血量更少,值得临床推广。     

三种胆囊切除术式治疗胆囊结石及胆总管结石的疗效观察

目的探讨三种胆囊切除术式治疗胆囊结石与胆总管结石的临床疗效。方法随机选取广州市天河区红十字会医院2009年6月至2012年5月确诊并采取胆囊切除及胆总管切开取石术治疗的胆囊结石合并胆总管结石患者90例,其中33例采取常规腹腔镜手术、27例小切口手术和30例传统开腹手术。观察三组手术时间、术中出血量、住院时间、术后排气时间、术后并发症和结石残留率。结果小切口组与腹腔镜组手术时间、术中出血量、住院时间及术后排气时间均短于开腹组,差异有统计学意义(P<0.05),其中小切口组的手术时间和术中出血量小于腹腔镜组,差异有统计学意义(P<0.05);三组的术后并发症和结石残留率比较差异无统计学意义(P>0.05)。结论小切口和腹腔镜手术治疗胆囊结石与胆总管结石的疗效显著,与开腹治疗疗效相当,且具有创伤小、手术时间短及术后恢复快等优点。     

腹腔镜胆囊大部切除术治疗复杂胆囊结石的临床疗效观察

选取120例复杂性胆囊结石患者按随机数字表法分成研究组和对照组各60例。两组患者均采用胆囊大部切除术进行治疗,研究组为腹腔镜手术,对照组为开腹手术。对比两组手术时间、术中出血量、肛门排气时间、切口疼痛、住院时间及并发症发生率。结果研究组手术时间较对照组长(P<0.01);研究组术中出血量较对照组少(P<0.01);研究组肛门排气时间及住院时间较对照组短(P<0.01);研究组切口疼痛得分低于对照组(P<0.01);研究组并发症总发生率低于对照组(P<0.05)。腹腔镜胆囊大部切除术治疗复杂胆囊结石虽手术时间较长,但术中出血较少,具有术后疼痛轻、恢复快、并发症少的优势,是更为合适的治疗方式。     

高龄胆囊结石病人行腹腔镜胆囊切除术的护理干预效果观察

[目的]观察高龄胆囊结石病人行腹腔镜胆囊切除术（LC）的护理干预效果.[方法]将高龄胆囊结石行LC病人随机分为观察组和对照组各50例,对照组采用常规护理.观察组在常规护理基础上给予护理干预.比较两组病人术后并发症、切口感染发生情况及切口愈合时间、住院时间.[结果] 两组病人术后并发症、切口感染少于对照组,切口愈合时间、住院时间短于对照组（P＜0.05）.[结论] 高龄胆囊结石行LC病人围术期内给予护理干预可以减少术后并发症、切口感染的发生,缩短切口愈合时间以及住院时间.     

Long Term Results of Venesection Therapy in Idiopathic Haemochromatosis

Observations on the clinical effects of venesection therapyin 85 treated, as compared with 26 untreated, patients withidiopathic haemochromatosis showed decreased pigmentation andhepatomegaly together with a return to normal tests of liverfuntion in half the patients who had abnormal tests at presentation.Control improved in 28 per cent of those patients with diabetesmellitus, although some patients developed it during the periodof observation, despite venesection. Portal hypertension, testicularatrophy and arthropathy were not improved. In only 12 patientswas there sufficient reaccumulation of iron after the initialcourse of venesection to merit further treatment. Rates of ironaccumulation in these patients varied between 1·4 mgand 4·8 mg per day and chelatable iron levels were notedto be inappropriately high in relation to body iron stores duringthe early stages of the reaccumulation period. Life table datashows that the percentage survival five and ten years afterdiagnosis was 66 and 32 per cent respectively for the treatedpatients, and 18 and 6 per cent respectively for the untreatedpatients, both statistically highly significant differences(p < 0·01). Possible clinical differences such asage of presentation, the presence of diabetes mellitus, cirrhosis,clinical hepatic failure and hepatoma between the treated anduntreated groups that might otherwise have weighted survivalin favour of the treated group were corrected by the use ofcovariant analysis. This gave mean log survival values of 4·15and 2·88 for the treated and untreated patients respectively,equivalent to 63·4 months and 17·8 months, a highlysignificant difference (p < 0·01). Ten patients, allof whom had cirrhosis at the time of diagnosis, died of malignanthepatoma between three and 15 years after completing venesectiontherapy. There was also a high rate of death from neoplasmsin a variety of other sites—22 per cent in the venesectedgroup, strikingly higher than that rate predicted for a similarlyaged population using national cancer mortality rates.     

Episodic Cluster Headache: Short and Long Term Results of Prophylactic Treatment

SYNOPSIS
We reviewed our experience with episodic cluster headache patients to evaluate both short and long term results of prophylactic treatment. 50 patients (46 M - 4 F) with episodic cluster headache were studied. During a follow-up period (mean duration 27.5 months, range 12–84) we studied: response to prophylactic treatment, relapses in responders, and response to the same prophylactic treatment when repeated in subsequent bouts. Drugs used were: Prednisone 50 mg/day; Nimodipine 120 mg/day; Lithium Carbonate 900 mg/day and Methysergide 6 mg/day. The patients were treated at the start of the cluster (within the first week of a bout); successful outcome was defined as the disappearance of attacks within seven days of treatment. Prednisone and Nimodipine gave positive results in over 50% of cases, Lithium Carbonate in 40% of cases, Methysergide in less than 30% of cases. Prednisone presented 33% of relapses; less relapses occurred with Lithium and Nimodipine.
Treatment effectiveness tends to diminish in subsequent bouts irrespective of the drug used.     

The Continuum of Long Term Care:

No abstract available for this article.     

A Family Psychoeducation Model for Long Term Rehabilitation

When one member of a family is medically compromised, the combined effects of disability and institutional stressors jeopardize the integrity and adaptive strength of the patients and the family. A psychoeducational program was designed to meet the needs of patients, families, and staff of a 912-bed chronic rehabilitation and nursing facility. Results are discussed in terms of positive changes in patient, family, and staff relationships, the utility of a family group intervention and its unique relevance as a preventive as well as rehabilitative treatment.     

负压抽吸法治疗肢体淋巴水肿的远期疗效分析

目的:分析应用负压抽吸法治疗四肢淋巴水肿的远期疗效结果。方法:自1999年2月开始应用单纯负压抽吸法治疗四肢淋巴水肿,采用问卷方式对疗效进行分析,发出问卷45份,回复问卷17份。其中上肢淋巴水肿7例,下肢淋巴水肿10例。对肢体周径的变化以及丹毒控制的治疗效果加以调查。结果:平均随访时间4.63年。术后肢体的周径明显缩小,应用弹性绷带或弹力袜加压包扎,维持3~12个月,平均维持6个月左右,之后恢复到术前水平。丹毒发作术前平均每年3.41次,抽吸术后丹毒发作消失,平均约2.21年后丹毒发作开始出现。患者满意率67.66%,不满意的原因主要是对肢体肿胀控制的维持时间较短,以及弹力套使用不方便。结论:应用抽吸法可以有效地控制丹毒发作,一段时间内可以减轻肢体肿胀,改善外形。对于具有部分淋巴回流功能的轻中度肢体淋巴水肿患者抽吸法是可供选择的有效治疗方法。     

Long Term Outcomes of Preterm Birth: The Role of Epigenetics

It is well established that preterm birth is associated with an increased risk for major neurosensory impairments. In addition to this, “minor” or “high prevalence/low severity” morbidities can significantly impact school performance and are prevalent in more than 50 percent of preterm survivors. Despite improved neuroimaging techniques and understanding of the factors contributing to brain injury in this population, there continues to be significant difficulty in defining what factors influence risk for adverse outcome in this population. The emerging field of epigenetics may shed additional light on this issue. The purpose of this paper is to examine the possible contributions of epigenetic processes relative to adverse neurodevelopmental outcome and to review nursing interventions which may reduce or ameliorate this risk.     

超声心动图评估法洛四联症术后中远期疗效109例随访

目的：运用超声心动图评价法洛四联症手术后的中远期疗效。方法：从1994年1月至2000年2月共109例法洛四联症手术病例,男性81例,女性28例,年龄5－158月,体重6－43kg。一期根治105例,二期根治4例（首期采用右室流出道跨瓣补片）。79例行右室流出道跨瓣补片,2例采用人造血管连接右心室与肺动脉,其余病例行右室流出道不跨瓣补片。术后超声心动图随1-72月。结果：术后残余分流20例（18．3％）,70％的残余室间隔缺损直径为0．1－0．2cm,不引起左半心内径增大,但有1例发生细菌性心内膜炎。术后残余右室流出道梗阻2例（1．8％）。肺动脉瓣返流85例（77．9％）,返流组右心室扩大率显著高于无返流组（92．9％vs20．8％,P＜0．001）.4例二期根治患者中有3例首期术后出现肺动脉高压。结论：法洛四联症结术后总体中远期疗效满意。较高的肺动脉瓣返流率值得引起重视。对残余分流和姑息术后的病例应加强随访。     

胃癌术后免疫化疗的远期疗效评价

目的：为探讨术后免疫化疗在胃癌综合治疗中的远期疗效，本文对428例胃癌进行回顾性分析。方法：全部资料来自我院、西安交通大学第一附属医院1989／2001年收治的428例胃癌患者，并随机分为单纯手术组144例，术后化疗组138例，术后化疗免疫组146例。化疗组均给于术后化疗1～3a，观察其5a生仔率。结果：（1）单纯手术、术后化疗及术后免疫化疗组5a生存率分别为24．3％、38．4％和53．4％。术后免疫化疗组与单纯手术组间差异有显著性（P〈0.01）；5a生存率术后免疫化疗组较术后化疗组提高15．0％。（2）无淋巴结转移组中，单纯手术组，术后化疗组及术后免疫化疗组5a生存牢分别为29．3％、51．9％、66．7％。术后免疫化疗组与单纯手术组差异有显著性（P〈0．01），较术后化疗组5a生存率提高14．8％；有淋巴结转移组中，单纯下术组，术后化疗组及术后免疫化疗组5a生存率分别为14．8％、29．8％、44．2％。术后免疫化疗组与单纯手术组差异有显著性（P〈0.01），较术后化疗组5a生存率提高14．4％。结论：胃癌术后免疫化疗呵提高患者的生存期，其远期疗效明显优于术后化疗及单纯手术。对有／无淋巴结转移者，术后免疫化疗均有明显的远期疗效。